Identifying factors associated with quit intentions among smokers from two nationally representative samples in Africa: Findings from the ITC Kenya and Zambia Surveys

Abstract

It is well established that intentions to quit smoking is the strongest predictor of future quit attempts. However, most studies on quit intentions have been conducted in high-income countries with very few in low- and middle-income countries particularly in Africa. This is the first population-based study to compare factors associated with quit intentions among smokers in two African countries. Data were from the International Tobacco Control (ITC) Kenya and Zambia Surveys (2012), face-to-face surveys of nationally representative samples of 2291 adult smokers (Kenya = 1103; Zambia = 1188). Multivariate logistic regression analyses were conducted to identify predictors of quit intentions. Most Kenyan (65.1%) and Zambian (69.1%) smokers had quit intentions of which 54.8% planned to quit within the next 6 months. Five factors were significantly associated with quit intentions in both countries: being younger, having tried to quit previously, perceiving that quitting is beneficial to health, worrying about future health consequences of smoking, and being low in nicotine dependence. The predictive strength of these factors did not differ in the two countries. Four additional factors were significant predictors in Zambia only: having a quit attempt lasting six months or more, lower smoking enjoyment, having a negative opinion about smoking, and concern about cigarette expenses. The factors predicting quit intentions were similar to those in other ITC countries including Canada, US, UK, China and Mauritius. These findings highlight the need for stronger tobacco control policies in Kenya and Zambia including increased taxation, greater access to cessation services, and anti-smoking campaigns denormalizing tobacco use.

Health Knowledge about Smoking, Role of Doctors, and Self-Perceived Health: A Cross-Sectional Study on Smokers’ Intentions to Quit

“…Firstly, smokers’ belief about the health risks of smoking influences their decision to quit. This is in line with [ 12 , 20 , 21 ], where smokers who reported greater worry about the future health effects of smoking and smokers who reported health benefits from quitting are likely to consider quitting. On the other hand, self-reported health status is a good measure of the general health status of an adult.…”

Who Are More Likely to Have Quit Intentions among Malaysian Adult Smokers? Findings from the 2020 ITC Malaysia Survey

“…Factors that are associated with quit intentions include higher perceived vulnerability to disease [ 23 ], self-efficacy [ 10 , 23 , 26 ], past quit attempts [ 23 , 27 , 28 , 29 , 30 ], nicotine dependence [ 28 ], duration of past quit attempts, outcome expectancy of quitting, worry about future health because of tobacco use [ 20 , 27 , 28 , 31 ], overall opinion of smoking [ 28 , 29 ], and subjective norms [ 29 ]. In addition, income, education [ 32 ], being male, and having a spouse [ 10 , 26 ] have all been shown to be predictive of quit intentions.…”

Demographic characteristics associated with awareness of cigarette health warnings and thinking about quitting among current adult cigarette smokers in Zambia, 2017

“…We found that certain sociodemographic characteristics were significantly associated with awareness of health warnings and thinking about quitting among all adults who currently smoked. Even though the proportion of female current tobacco smokers in Zambia was relatively low, our finding that women were less likely to notice health warnings and think about quitting than men is like that reported in some Asian countries such as Vietnam, Malaysia and Thailand 20,21,26,[30][31][32] . Women, especially those of low socioeconomic status, may be generally less responsive to tobacco control interventions than men not only because fewer women attain higher levels of education compared to men in Zambia 7 , but there has also been limited integration of gender considerations into multiple elements of tobacco control policies, including messages on the harms of tobacco use [33][34][35] .…”

“…Some countries in the African region such as Uganda and Mauritius are addressing the tobacco epidemic by strengthening implementation of the WHO FCTC; in particular, introducing pictorial health warnings covering more than 65% of tobacco product packaging 14,15 . Several studies that assessed the impact of health warnings concluded that pictorial health warnings were more effective than singletext warnings in achieving increased awareness and knowledge of tobacco harms, encouraging thinking about quitting among people who currently smoke, and preventing smoking initiation among people who do not smoke 13,[16][17][18][19][20][21][22] .…”